Wang Yuxia, Zhang Chao, Zhang Yunzhu, Zhang Zhuwei
Geriatric Medicine Center, Department of Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Department of Neurosurgery, Linyi City People's Hospital, Linyi, China.
Rev Med Virol. 2025 Sep;35(5):e70069. doi: 10.1002/rmv.70069.
The central nervous system is a potential target of the COVID-19 virus, and one of the devastating neurological consequences of this infection is cerebral haemorrhage (ICH). Cerebral haemorrhage is a leading cause of death worldwide. This study aimed to systematically review and analyse the existing literature on this topic and provide insights into the potential neurological consequences of COVID-19. A comprehensive search was conducted across the PubMed, Scopus, Web of Science, and Embase databases to extract relevant published data up to February 2025. This meta-analysis included 11 studies involving a total of 197,060 individuals. Subgroup analyses were performed based on the year of publication, hospital sampling wards, and study design. A critical appraisal was carried out using the Newcastle-Ottawa Scale (NOS) score. Risk was utilised as a measure of pooled effect size based on a random-effects model. In this analysis, we identified 11 articles that directly assessed the risk of cerebral haemorrhage. The reported risk of cerebral haemorrhage was five cases per 10,000 COVID-19 patients [0.005 (95% CI: 0.002-0.009), p < 0.001]. Notably, studies published in 2022 and 2023 indicated a significantly higher risk of cerebral haemorrhage compared to earlier years. COVID-19 patients admitted to the intensive care unit (ICU) faced an increased risk of cerebral haemorrhage compared to those admitted to general wards. Meta-regression analysis revealed a statistically significant association between the risk of cerebral haemorrhage and the type of wards in a hospital [0.0089 (95% CI: 0.0067-0.0112), p < 0.001], as well as the year of publication [0.0004 (95% CI: 0.0003-0.0008), p = 0.048]. Therefore, it is essential to evaluate COVID-19 patients admitted to the ICU in recent years for the potential occurrence of cerebral haemorrhage.
中枢神经系统是新冠病毒的一个潜在靶点，这种感染造成的毁灭性神经后果之一是脑出血（ICH）。脑出血是全球范围内的主要死因。本研究旨在系统回顾和分析关于该主题的现有文献，并深入了解新冠病毒潜在的神经后果。通过对PubMed、Scopus、科学网和Embase数据库进行全面检索，以提取截至2025年2月的相关已发表数据。该荟萃分析纳入了11项研究，共涉及197,060名个体。根据发表年份、医院抽样病房和研究设计进行了亚组分析。使用纽卡斯尔-渥太华量表（NOS）评分进行了严格评价。基于随机效应模型，将风险用作合并效应量的度量。在本分析中，我们确定了11篇直接评估脑出血风险的文章。报告的脑出血风险为每10,000名新冠患者中有5例[0.005（95%置信区间：0.002 - 0.009），p < 0.001]。值得注意的是，2022年和2023年发表的研究表明，与早期相比，脑出血风险显著更高。与入住普通病房的患者相比，入住重症监护病房（ICU）的新冠患者面临的脑出血风险增加。荟萃回归分析显示，脑出血风险与医院病房类型[0.0089（95%置信区间：0.0067 - 0.0112），p < 0.001]以及发表年份[0.0004（95%置信区间：0.0003 - 0.0008），p = 0.048]之间存在统计学上的显著关联。因此，有必要对近年来入住ICU的新冠患者进行脑出血潜在发生情况的评估。
